Chronic Vomiting in Dogs

Vomiting refers to the stomach expelling its contents and is the body’s means of dispelling harmful substances including foreign objects and toxins. Acute vomiting is an occasional isolated incident of vomiting, often not serious and the result of eating something disagreeable, a diet change, eating too fast, etc. Chronic vomiting is ongoing vomiting (more than once in a day) and should be treated quickly, as it can indicate a life threatening situation. Chronic vomiting can itself make conditions worse due to inadequate nutrition and dehydration if allowed to continue without treatment. An occasional bout of vomiting is not uncommon in dogs; however, persistent, chronic vomiting is usually indicative of an underlying disease. Chronic vomiting often leads to decreased absorption of nutrients and subsequent weight loss. Chronic vomiting is ongoing vomiting (more than once in a day) and should be treated quickly, as it can indicate a life threatening situation.

Symptoms of chronic vomiting include:

• Heaving/Gagging
• Vomiting more than once during a day
• Producing partially digested food
• Producing yellow fluid (bile)
• Producing white foam
• Producing mucus or watery substance
• Producing blood or blood-tinged substance

Causes of chronic vomiting include:

• Change in diet
• Food sensitivity/intolerance
• Garbage ingestion/bone ingestion
• Toxin ingestion (heavy metal/pesticide/auto coolant/chocolate)
• Intestinal parasites
• Chronic cough
• Motion sickness
• Ingestion of a foreign object
• Intestinal obstruction
• Severe constipation
• Bacterial infection
• Viral infection
• Cancer
• Enteritis/Colitis
• Ulcer
• Peritonitis
• Pyometria (in intact females)
• Diabetes
• Vestibular disease
• Septicemia
• Addison’s disease
• Pancreatitis
• Kidney failure
• Liver failure
• Ketoacidosis
• Bladder obstruction or rupture
• Volvulus (bloat) or gastric dilatation

Types

• Vomiting: Expelling contents of the stomach
• Regurgitating: Expelling contents from the esophagus that have not yet reached the stomach

If your pet has vomited once and is bright and alert and eating and going to the bathroom normally, the vomiting may be an isolated incident. However, keep an eye out for more vomiting, inability to keep food down, and abnormal or absent bowel movements for the next few days.

If your pet has continued to vomit you should take them to the veterinarian as it could be an indication of poisoning or other life threatening condition. Collect a sample of the vomit in a plastic bag or container if possible for the vet to examine. The veterinarian will take a history to determine if your pet has ingested garbage, a foreign object or toxic substance. She will want to know when the vomiting started, how frequently it has been occurring, and what the vomit looks like (does it contain food, yellow bile, mucous, foam, blood).

The veterinarian will perform a physical exam and palpate the abdomen to feel for any abdominal masses or other abnormalities. Depending on the pet’s history and physical exam, the following diagnostic tools may be employed to determine the cause of the vomiting and appropriate treatment.

• Radiographs: X-ray can help visualize tumor, foreign body, or other abnormality.
• Endoscopy/colonoscopy: Can help visualize tumor, foreign body, or other abnormality.
• Bloodwork: Examines function of the liver, kidneys and other body systems.
• Ultrasound: Aids in visualization of the intestines and stomach contents.
• Fecal examination: Examines bowel contents and presence of intestinal parasites.
• Exploratory surgery: When the cause of chronic vomiting cannot be resolved or when other diagnostics indicate a mass or foreign body, exploratory surgery may be necessary.

Depending on the results of the diagnostics and extent and duration of the vomiting, the following treatments may be utilized to stop the vomiting and address the abnormality:

Bland Diet

The veterinarian may recommend feeding your pet a bland diet for a period of a few days. A bland diet consists of foods that are gentle on the digestive system while providing the necessary nutrients. It is low in fiber, fat and protein and high in carbohydrates, composed of a single lean protein source and a single carbohydrate. The most common bland diet consists of boiled white rice and boiled skinless chicken breast (no bones). Cottage cheese, cooked egg whites and low-fat yogurt are also permitted. There are a number of commercial bland diets you can ask your veterinarian about.

The bland diet should be fed as long as your veterinarian recommends. Once the bland diet can be stopped, the regular diet should be introduced gradually over a 3-7 day period, adding a small amount of regular food to the bland diet a bit more each day until the pet is eating only regular food.

Medications

• Anti-emetics – Prevent nausea and vomiting
• Antibiotics – Treat infection
• Corticosteroids – Treat inflammation
• IV fluid therapy – Restores electrolytes and rehydrates
• Subcutaneous fluid therapy – Restores electrolytes and rehydrates
• Dewormer – Rids of intestinal parasites

Surgery

In the case of a foreign body, pyometra or tumor, surgery may be required to treat the condition. Foreign body and pyometra surgeries are often emergency situations and performed the same day of diagnosis. The pet will likely spend up to 72 hours in the hospital to be monitored for recovery as this is an invasive procedure. After surgery and hospitalization, when the pet is allowed to go home, they are supplied with medications for pain, antibiotics, and possible other medications. They will be given an Elizabethan collar (cone/e-collar) to prevent licking at the incision site. The pet will have staples or sutures removed in 1-2 weeks. In case of surgery, it is important the pet remain quiet and inside the house in a clean environment, usually for a period of at least two weeks. 

If a pet has been vomiting or is nauseous, it may be necessary to provide food and water in small portions over an extended period of time rather than offer a full water bowl or full meal. This prevents the pet from choking or ingesting too much material at once on a sensitive stomach.

It is important to follow your treatment plan as indicated by the veterinarian. Dietary changes, medication management and/or surgery recovery guidelines will produce positive results if correctly applied. Monitor your pet carefully and be aware of any changes in eating and bowel movements. If vomiting continues, be sure to alert your veterinarian.

To prevent gastrointestinal problems that can be costly and difficult to manage in your pet, be sure to keep garbage, human food, chemicals and laundry items like socks, washcloths, and other small fabric items out of reach of your pet. Choose toys that are not easily destroyed and that will not be swallowed easily.